SGA Practicing Hygienist Survey

Name (First and Last) *

Your answer

Phone Number *

Your answer

Email *

Your answer

Current Practice and State *

Your answer

Do you have your local anesthetic license? *

Yes

No

Have you worked for SGA Dental Partners before? *

Yes

No

Are you willing to travel? *

Yes

No

Are you looking for a Full-time or Part-time role? *

Full-time

Part-time

Do you have a preference in what kind of practice that you would like to work for? Check all that apply:

Pediatric

General Practice

Periodontics

Orthodontics

Oral Surgery

Is there a city or state that you would prefer to practice in?

*

Your answer